UCLA Center for Health Policy Research

The continued decline of employment-based coverage in California and more than 6.6 million uninsured residents are major reasons for concern, since health insurance is the primary means by which health care for employed persons and their families is financed in the state. California employers have different advantages in the provision of health insurance to their employees depending on their firm size. Unlike large and small firms, California's mid-size groups are thought to be particularly vulnerable due to lack of regulatory protection and lack of negotiating power. This brief characterizes California's mid-size market and explores whether there are viable options for enhancing the current market dynamics and improving the ability of mid-size firms to provide affordable health insurance to their employees. The first section describes key characteristics of insurance coverage in this market. The second section reports on a series of interviews with various stakeholders in this segment to identify viable options for market reform.